SUPPORT for Patients and Communities Act – Impact on Open Payments

On October 24, 2018, President Trump signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). This Act impacts Open Payments in the following ways:

Expands the Open Payment’s definition of a covered recipient to include five additional provider types:

Physician Assistants

Nurse practitioners

Clinical nurse specialists

Certified registered nurse anesthetists

Certified nurse midwives

Phases out the exclusion from making National Provider Identifiers (NPIs) publicly available

On Friday November 1, 2019, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. The final rule also included several changes to the Open Payments Program.

Under this Final Rule the Open Payments program is impacted in the following ways:

In response to the statutory changes included in the SUPPORT Act the definition of a “covered recipient” is expanded to include five additional provider types.
The added provider types are:

Physician assistants,

Nurse practitioners,

Clinical nurse specialists,

Certified registered nurse anesthetists, and

Certified nurse midwives. This is in response to statutory changes included in the SUPPORT Act

The Nature of Payment categories are updated to include three new categories:

debt forgiveness,

long term medical supply or device loan, and

acquisitions

In addition, the two categories related to education programs will be combined into one.

Standardizing data on reported products

added reporting requirements for the ‘device identifier’ component of the unique device identifier for devices and medical supplies.

Effective Dates:

Per the SUPPORT Act, the changes listed above apply to information required to be submitted on or after January 1, 2022.This will be effective for data collection beginning in calendar year 2021 as this is the data that will be reported to CMS in 2022.